KR20220070439A - Systems and methods for providing haptic guidance - Google Patents

Abstract

The method includes defining a virtual object and defining first and second points associated with the virtual representation of the surgical tool. The movement of the virtual representation of the surgical tool corresponds to the movement of the surgical tool in real space. The method includes controlling a robotic device coupled to a surgical tool to constrain a first point to a virtual object, determining that the first point is at a critical position along the virtual object, and guiding a second point to the virtual object and controlling the robot device to do so.

Description

Systems and methods for providing haptic guidance

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit and priority of U.S. Provisional Application Serial No. 62/908,890, filed on October 1, 2019, the entire disclosure of which is incorporated herein by reference.

The present disclosure relates generally to surgical systems for orthopedic surgery, eg, surgical systems to aid in joint replacement surgery. Arthroplasty (arthroplasty) is widely used to treat osteoarthritis and other damage to a patient's joint by replacing part of the joint with prosthetic components. Joint replacement surgery may include a procedure in which a hip, knee, shoulder, or other joint is replaced with one or more prosthetic components.

One possible tool for use in arthroplasty procedures is a robot-assisted surgical system. Robot-assisted surgical systems typically monitor a robotic device used to prepare a patient's anatomy for receiving an implant, a tracking system configured to monitor the position of the robotic device relative to the patient's anatomy, and the robotic device and and a computing system configured to control. Various types of robot-assisted surgical systems can autonomously perform surgical tasks, provide force feedback to users operating surgical devices to complete surgical tasks, increase surgeon dexterity and precision, and ensure safe and accurate surgical operations. Another search signal is provided to facilitate.

A surgical plan is usually established prior to performing a surgical procedure with a robot-assisted surgical system. Depending on the surgical plan, the surgical system guides, controls, or restricts movement of surgical instruments during part of the surgical procedure. Guidance and/or control of the surgical instruments serves to assist the surgeon during the execution of the surgical plan.

1 is a perspective view of a femur prepared to receive an implant component in accordance with an exemplary embodiment.
2 is an illustration of a surgical system in accordance with an exemplary embodiment.
3 is a flow diagram of a first process that may be performed by the surgical system of FIG. 2 in accordance with an exemplary embodiment.
4 is a flow diagram of a second process that may be performed by the surgical system of FIG. 2 in accordance with an exemplary embodiment.
Fig. 5 is an illustration of the process of Fig. 4 according to an exemplary embodiment.
6 is a flow diagram of a third process that may be performed by the surgical system of FIG. 2 according to an exemplary embodiment.
Fig. 7 is an illustration of a virtual control object that may be used in the process of Fig. 6 according to an exemplary embodiment.
Fig. 8 is a flow diagram of a fourth process that may be performed by the surgical system of Fig. 2 in accordance with an exemplary embodiment.
9 is a flow diagram of a fifth process that may be performed by the surgical system of FIG. 2 according to an exemplary embodiment.
Fig. 10 is an illustration of a virtual control object that may be used in the process of Fig. 9 according to an exemplary embodiment.
11 is a flow diagram of a sixth process that may be performed by the surgical system of FIG. 2 according to an exemplary embodiment.
12 is a flow diagram of a seventh process that may be performed by the surgical system of FIG. 2 according to an exemplary embodiment.
13 is a flow diagram of an eighth process that may be performed by the surgical system of FIG. 2 according to an exemplary embodiment.

content of the invention

One implementation of the present disclosure relates to a method for controlling a robotic device. The method includes defining a virtual object and defining first and second points associated with the virtual representation of the surgical tool. Movement of the virtual representation of the surgical tool corresponds to movement of the surgical tool in real space. The method includes controlling a robotic device coupled to a surgical tool to confine a first point to the virtual object, determining that the first point is at a critical position along the virtual object, and the robot to guide a second point to the virtual object. controlling the device.

Another implementation of the present disclosure relates to a system including a robotic device and processing circuitry capable of communicating with the robotic device. The processing circuitry may be configured to define a virtual object and define first and second points associated with the virtual representation of the surgical tool. The processing circuitry is configured such that movement of the virtual representation of the surgical tool corresponds to movement of the surgical tool in real space. the processing circuitry is coupled to the surgical tool to control the robotic device to limit the first point to the virtual object, determine that the first point is at a critical position along the virtual object, and guide the second point to the virtual object is further configured to control

Another implementation of the present disclosure relates to a method of operating a robotic device to which a tool is coupled. The method includes controlling the robotic device to constrain the surgical tool based on the first haptic object; receiving a signal and a user-defined direction; and adjusting the haptic control interaction in response to the signal by expanding the first haptic object in a user-defined direction.

Another implementation of the present disclosure relates to a system including a robotic device and processing circuitry capable of communicating with the robotic device. The processing circuitry configures the robotic device to adjust the haptic control interaction in response to the signal by confining the surgical tool based on the first haptic object, receiving a signal and a user-defined direction, and extending the first haptic object in the user-defined direction. configured to control.

Another implementation of the present disclosure relates to a method of operating a robotic device to which a tool is coupled. The method includes controlling the robotic device to constrain a tool based on a first haptic object, receiving a signal and a user-defined direction, and adjusting a haptic control interaction in response to the signal by adjusting a virtual dimension of the tool. includes

Another implementation of the present disclosure relates to a system including a robotic device and processing circuitry communicable with the robotic device. The processing circuitry controls the robotic device to constrain the tool based on the first haptic object, receive a signal and a user-defined orientation, and adjust the haptic control interaction in response to the signal by adjusting a virtual dimension of the tool.

Another implementation of the present disclosure relates to a method of operating a robotic device. The method includes tracking movement of a tool coupled to a robotic device, determining a direction of movement of the tool, determining whether the direction of movement is toward a virtual control object, and determining that the direction of movement is toward a virtual control object. in response, controlling the robotic device to guide the tool to the virtual control object.

Another implementation of the present disclosure relates to a system including a robotic device and processing circuitry capable of communicating with the robotic device. The processing circuitry receives tracking data indicative of movement of a tool coupled to the robotic device, determines a direction of movement of the tool, determines whether the direction of movement is toward the virtual control object, and determines whether the direction of movement is toward the virtual control object. and in response to the determination, control the robotic device to guide the tool to the virtual control object.

Another implementation of the present disclosure relates to a method of operating a robotic device. The method includes tracking a tool coupled to the robotic device, controlling the robotic device to constrain the tool within the virtual control object, defining a zone of the virtual control object, determining whether the tool is in the zone, and the zone. and controlling the robotic device to resist movement of the tool in the .

Another implementation of the present disclosure relates to a system including a robotic device and processing circuitry capable of communicating with the robotic device. the processing circuitry is configured to control the robotic device to limit the tool within the virtual control object, define a zone of the virtual control object, determine whether the tool is within the zone, and control the robotic device to resist movement of the tool in the zone .

Another implementation of the present disclosure relates to a method of operating a robotic device to which a tool is coupled. The method comprises the steps of limiting a tool to a virtual control object by a robotic device, detecting a force applied to the tool in an approximately predetermined direction, determining whether the force in the approximately predetermined direction exceeds a threshold force; and in response to determining that the force in the approximately predetermined direction exceeds the threshold force, controlling the robotic device such that the tool ejects the virtual control object.

Another implementation of the present disclosure relates to a system including a robotic device and processing circuitry capable of communicating with the robotic device. The processing system controls the robotic device to limit the tool to the virtual control object, detect a force applied to the tool in an approximately predetermined direction, determine whether the force in the approximately predetermined direction exceeds a threshold force, and In response to determining that the force in the approximately predetermined direction exceeds the threshold force, the tool is configured to control the robotic device to eject the virtual control object.

DETAILED DESCRIPTION OF THE INVENTION

A presently preferred embodiment of the invention is illustrated in the drawings. Efforts have been made to use the same or like reference numbers throughout the drawings to refer to the same or like parts. Although this specification mainly refers to robotic arms for orthopedic joint replacement, the subject matter described herein can be used for surgery on other anatomical areas, such as spine or dental surgery, as well as those used for non-surgical applications. It should be understood that it may be applied to other types of robotic systems, including

Referring now to FIG. 1 , a deformed femur 101 is shown during knee arthroplasty surgery in accordance with an exemplary embodiment. As shown in Fig. 1, the femur 101 was altered with a multi-planar cut. In the illustrated example, the femur 100 has five substantially planar surfaces: a distal surface 102 , a posterior chamfer surface 104 , a posterior surface 106 , an anterior surface 108 and an anterior chamfer surface 110 . was altered by five substantially planar cuts to create The planar surface may be achieved using a sagittal saw or other surgical tool, for example a surgical tool coupled to a robotic device as in the examples described below. The planar surfaces 102 - 110 are created such that the planar surfaces 102 - 110 mate with corresponding surfaces of the femoral implant component. The position and angular orientation of the planar surfaces 102 - 110 may determine the alignment and positioning of the implant components. Thus, operating a surgical tool to create planar surfaces 102 - 110 with high accuracy may improve the outcome of joint replacement surgery.

As shown in FIG. 1 , the femur 101 was also changed to have a pair of pilot holes 120 . The pilot hole 120 extends into the femur 101 and the pilot hole 120 may receive a screw, a protrusion extending from the surface of the implant component, or other structure configured to aid in engagement of the implant component to the femur 101 . can The pilot hole 120 may be created using a drill, spherical burr, or other surgical tool as described below. The pilot hole 120 may have a pre-planned position, orientation, and depth, which facilitates secure engagement of the implant component to the bone in the desired position and orientation. In some cases, the pilot hole 120 is designed to intersect high-density regions of bone and/or to prevent other implant components and/or sensitive anatomical features. Therefore, manipulating the surgical tool to create the pilot hole 120 with high accuracy may improve the outcome of joint replacement surgery.

In some embodiments, the systems and methods described herein provide robotic assistance for creating planar surfaces 102 - 110 and pilot holes 120 . The five planar cuts and the creation of two cylindrical pilot holes as shown in Figure 1 are exemplary only, and the systems and methods described herein can be used, for example, in various embodiments for the preparation of any bone and/or joint. It is to be understood as contemplating and facilitating the creation of any number of planar or non-planar cuts, any number of pilot holes, any combination thereof, and the like. For example, in hip or shoulder arthroplasty surgery, a spherical bur may be used to ream a curved surface configured to receive a curved implant cup in accordance with the systems and methods herein. Additionally, in other embodiments, the systems and methods described herein may be used to facilitate placement of an implant component relative to a bone (eg, to facilitate impact of a cup implant in hip arthroplasty surgery). have. Many such surgical and non-surgical implementations are within the scope of the present disclosure.

Referring now to FIG. 2 , shown is a surgical system 200 for orthopedic surgery in accordance with an exemplary embodiment. In general, surgical system 200 is configured to facilitate the planning and execution of surgical plans, for example, to facilitate joint-related surgery. As shown in FIG. 2 , the surgical system 200 is configured to treat the leg 202 of a patient 204 sitting or lying on a table 205 . As shown in FIG. 2 , the leg 202 includes a femur 206 (eg, femur 101 of FIG. 1 ) and a tibia 208 , between which an artificial knee implant is placed over a full knee arthroscopically. transplanted in surgery. In another scenario, the surgical system 200 is configured to treat a patient's hip joint, ie, the patient's femur and pelvis. Additionally, in another scenario, the surgical system 200 may be used to treat a patient's shoulder, ie, to facilitate replacement and/or augmentation of a component of the shoulder joint (eg, a humerus component, a scapular component). to facilitate the placement of the graft or implant reinforcement) is established. Various other anatomical areas and surgeries are also possible. To facilitate surgery, surgical system 200 includes robotic device 220 , tracking system 222 , and computing system 224 .

The robotic device 220 is configured to alter a patient's anatomy (eg, the femur 206 of the patient 204 ) under control of the computing system 224 . One embodiment of the robotic device 220 is a haptic device. "Haptic" means touch and the field of haptics relates, among other things, to human interactive devices that provide feedback to the operator. Feedback may include, for example, a tactile sensation such as vibration. Feedback may also include providing the user with a force, such as a positive force or resistance to movement. One use of haptics is to provide a device user with guidance or restrictions on manipulation of the device. For example, a haptic device may be coupled to a surgical tool that may be manipulated by a surgeon to perform a surgical procedure. The surgeon's manipulation of the surgical tool may be guided or limited through the use of haptics to provide feedback to the surgeon during manipulation of the surgical tool.

Another embodiment of the robotic device 220 is an autonomous or semi-autonomous robot. “Autonomy” relates to the ability of a robotic device to act independently or semi-independently from human control by collecting information about its situation, determining a course of action, and automatically carrying out that course of action. For example, in this embodiment, the robotic device 220 in communication with the tracking system 222 and the computing system 224 can autonomously complete the series of femoral amputations described above without direct human intervention.

The robotic device 220 includes a base 230 , a robotic arm 232 , and a surgical tool 234 , and is communicatively coupled to a computing system 224 and a tracking system 222 . Base 230 provides a movable base for robotic arm 232 , enabling robotic arm 232 and surgical tools 234 to be repositioned as needed relative to patient 204 and table 205 . make it Base 230 may also include power systems, computing elements, motors, and other electronic or mechanical systems necessary for the functioning of robotic arm 232 and surgical tool 234 described below.

The robotic arm 232 is configured to support the surgical tool 234 and to provide force as directed by the computing system 224 . In some embodiments, robotic arm 232 enables a user to manipulate a surgical tool and provides force feedback to the user. In this embodiment, the robotic arm 232 allows a motor, actuator, or user to freely translate and rotate the robotic arm 232 and surgical tool 234 through an acceptable pose, while at the same time allowing the computing system ( and a mount 238 and an articulation 236 including other mechanisms configured to provide force feedback to limit or prevent some movement of the robotic arm 232 and surgical tool 234 as indicated by 224 . do. As will be described in detail below, thereby, the robotic arm 232 allows the surgeon to fully control the surgical tool 234 within the object of control while simultaneously providing force feedback along the object's boundaries (eg, penetration of the boundary). It makes it possible to provide vibrations, forces that prevent or resist In some embodiments, the robotic arm positions the robotic arm as needed and/or as directed by the computing system 224 to complete certain surgical tasks including, for example, amputation at the femur 206 . It is configured to automatically move the surgical tool to a new position without direct user intervention.

Surgical tool 234 cuts, burrs, grinds, drills, partially excises, reshapes and/or otherwise deforms bone or cuts, burrs, grinds, drills, partially ablates, reshapes and/or deforms bone. otherwise configured to limit/limit movement of the device used to deform. Surgical tool 234 may be any suitable tool, and may be one of a number of tools that are interchangeably connectable to robotic device 220 . For example, as shown in FIG. 2 , surgical tool 234 includes a spherical burr 244 . In another example, the surgical tool may also include, for example, an orthopedic saw having blades aligned parallel to or perpendicular to the tool axis. The surgical tool may also be, for example, a drill having a rotating bit aligned parallel to or perpendicular to the tool axis. Surgical tool 234 may in various embodiments be a jig, drill guide, cutting guide, or the like, and is, for example, configured to have a saw, drill, or other instrument inserted therethrough. Surgical tool 234 may also include an implant component (eg, an implant component) while the implant component is screwed to the bone, attached (eg, spliced) to a bone or other implant component, or otherwise installed in a preferred location. , cup 28a, implant reinforcement, etc.) may be a holding arm or other support configured to hold in place. In some embodiments, surgical tool 234 is an impact tool configured to provide an impact force to the cup implant to facilitate fixation of the cup implant to the pelvis in a planned position and orientation.

Tracking system 222 tracks the patient's anatomy (eg, femur 206 and tibia 208) and robotic device 220 (ie, surgical tool 234 and/or robotic arm 232). to enable control of a surgical tool 234 coupled to the robotic arm 232 , to determine the location and orientation or other consequences of deformations formed by the surgical tool 234 , and to allow a user to control a bone (e.g., a bone (e.g., The femur 206 , tibia 208 , pelvis, humerus, scapula, etc.) applicable to various surgeries, surgical tools 234 , and/or robotic arm 232 may be visualized on the display of computing system 224 . More specifically, the tracking system 222 determines the position and orientation (ie, posture) of a subject (eg, surgical instrument 234 , femur 206 ) with respect to a frame of reference coordinates, and , to track (ie, continuously determine) the subject's posture during the surgical procedure. According to various embodiments, the tracking system 222 measures the relative angles of a non-mechanical tracking system (eg, an optical tracking system), a mechanical tracking system (eg, a joint 236 of the robotic arm 232 ). tracking), or any type of navigation system, including any combination of non-mechanical and mechanical tracking systems.

In the embodiment shown in FIG. 2 , the tracking system 222 includes an optical tracking system. Accordingly, the tracking system 222 includes a first fiducial tree 240 coupled to the tibia 208 , a second fiducial tree 241 coupled to the femur 206 , and a second fiducial tree 241 coupled to the base 230 . three fiducial trees 242 , one or more criteria coupled to surgical tool 234 , and a detection device 246 configured to detect the three-dimensional position of fiducials (ie, markers on fiducial trees 240 - 242 ). . The fiducial trees 240 and 241 may be coupled to other bones suitable for various surgeries (eg, pelvis and femur in hip arthroplasty surgery). The detection device 246 may be a camera or an optical detector such as an infrared sensor. The fiducial trees 240 - 242 are fiducials, the fiducials being markers configured to appear unambiguously on the optical detector and/or by the image processing system using data from the optical detector, for example by infrared radiation (e.g., It is readily detectable by the high reflectivity of the tracking system 222 (emitted by the elements). The stereoscopic arrangement of the cameras on the detection device 246 enables the location of each fiducial to be determined in 3D space via a triangulation approach. Each fiducial has a geometric relationship to a corresponding object, such that tracking the fiducial allows tracking of the object (e.g., tracing the second fiducial tree 241 is caused by the tracking system 222 to the femur 206). ), and the tracking system 222 may be configured to perform a registration process to determine or verify this geometric relationship. The unique arrangement of fiducials in fiducial trees 240 - 242 (ie fiducials in first fiducial tree 240 are arranged in a different geometry than fiducials in second fiducial tree 241 ) , thus allowing to distinguish the objects being tracked from each other.

Using the tracking system 222 of FIG. 2 or some other approach to surgical navigation and tracking, the surgical system 200 responds to the surgical tool 234 altering anatomical features or otherwise facilitating a surgical procedure. The position of the surgical tool 234 relative to the patient's anatomical features, eg, the femur 206 , may be determined. Also, using the tracking system 222 of FIG. 2 or an approach to surgical navigation and tracking, the surgical system 200 may determine the relative pose of the tracked bone.

Computing system 224 is configured to generate a surgical plan, control robotic device 220 in accordance with the surgical plan, to perform one or more bone alterations, and/or to facilitate implantation of one or more prosthetic components. Accordingly, the computing system 224 is communicatively coupled to the tracking system 222 and the robotic device 220 to facilitate electronic communications between the robotic device 220 , the tracking system 222 , and the computing system 224 . do. Computing system 224 may also receive a patient's medical history or other patient profile information, medical images, surgical plans, information related to surgical procedures, and information related to the performance of surgical procedures, eg, by accessing an electronic health record system. It may be connected to a network to perform various functions. Computing system 224 includes processing circuitry 260 and input/output device 262 .

Input/output device 262 is configured to receive user input and display output as needed for the functions and processes described herein. As shown in FIG. 2 , input/output device 262 includes a display 264 and a keyboard 266 . Display 264 provides, for example, surgical planning, medical images, settings and other options for surgical system 200 , status information related to tracking system 222 and robotic device 220 , and tracking system 222 . and display a graphical user interface generated by processing circuitry 260 that includes information about tracking visualizations based on the provided data. The keyboard 266 is configured to receive user input for these graphical user interfaces to control one or more functions of the surgical system 200 .

Processing circuitry 260 includes a processor and a memory device. A processor may be implemented as a general purpose processor, application specific integrated circuit (ASIC), one or more area programmable gate array (FPGA), group of processing components, or other suitable electronic processing component. A memory device (eg, memory, memory unit, storage device, etc.) is one or more devices (eg, for storing data and/or computer code for completing or facilitating the various processes and functions described herein) , RAM, ROM, flash memory, hard disk storage devices, etc.). The memory device may include volatile memory or non-volatile memory. The memory device may include a database component, a target code component, a script component, or any other type of information structure to support the various activities and information structures described herein. According to an exemplary embodiment, the memory device is communicatively coupled to the processor via processing circuitry 260 and for executing one or more processes described herein (eg, processing circuitry 260 and/or by a processor) contains computer code.

More specifically, processing circuitry 260 is configured to facilitate generation of a preoperative surgical plan prior to a surgical procedure. According to some embodiments, a preoperative surgical plan is developed to utilize a three-dimensional representation of the patient's anatomy, also referred to herein as a “virtual bone model”. A “virtual bone model” may include a virtual representation of cartilage or other tissue other than bone. To obtain a virtual bone model, the processing circuit 260 receives image data of an anatomy of a patient on which a surgical procedure is to be performed. The image data may be generated using any suitable medical imaging technique to image the relevant anatomical features, including computed tomography (CT), magnetic resonance imaging (MRI), and/or ultrasound. The image data is then segmented to obtain a virtual bone model (ie, regions in the image corresponding to different anatomical features are distinguished). For example, MRI-based scan data of a joint can be segmented to differentiate the bone from the surrounding ligaments, cartilage, previously implanted prosthetic components, and other tissues to obtain a three-dimensional model of the imaged bone.

Alternatively, the virtual bone model may be obtained by selecting a three-dimensional model from a database or library of bone models. In one embodiment, the user may use the input/output device 262 to select an appropriate model. In other embodiments, processing circuitry 260 may execute stored instructions to select an appropriate model based on images or other information provided about the patient. The bone model(s) selected from the database may then be modified based on specific patient characteristics to create a virtual bone model for use in surgical planning and implementation as described herein.

Then, a pre-operative surgical plan may be generated based on the virtual bone model. The surgical plan may be automatically generated by processing circuitry 260 , input by a user via input/output device 262 , or some combination of the two (eg, processing circuitry 260 may include a user-generated plan constrains some features of , and creates a user-changeable plan). In some embodiments, a surgical plan may be created and/or altered based on distraction measurements collected during surgery.

Preoperative surgical planning includes desired cuts, holes, surfaces, burs, or other changes to the patient's anatomy to be made using the surgical system 200 . For example, for total knee arthroscopic surgery, the preoperative plan is to include a distal surface, a posterior chamfered surface, a posterior surface, an anterior surface and It may include the cuts needed to form the anterior chamfer surface on the femur as well as the cuts needed to form the tibia with a surface(s) suitable for mating to a prosthesis to be joined to the tibia during surgery. As another example, the pre-operative plan may include changes necessary to form a hole (eg, pilot hole 120 ) in the bone. As another example, in hip arthroplasty surgery, the surgical plan may include burs and, where appropriate, implant reinforcements to form one or more surfaces in the acetabular region of the pelvis to receive the cup. Accordingly, processing circuitry 260 may receive, access, and/or store a model of the prosthesis to facilitate creation of a surgical plan.

The processing circuit 260 is further configured to generate a control object for the robotic device 220 according to the surgical plan. In some embodiments described herein, the control object may take various forms depending on the various types of possible robotic devices (eg, haptic, autonomous, etc.). For example, in some embodiments, the control object controls the robotic device to move within the control object (ie, to autonomously make amputations in one or more of the surgical plans guided by feedback from the tracking system 222 ). Defines the command for the robot device for In some embodiments, the control object facilitates surgical navigation and assists a surgeon in guiding a surgeon in following a surgical plan (eg, without active control or force feedback of a robotic device) for surgery on display 264 . Includes planning and visualization of robotic devices. In embodiments where the robotic device 220 is a haptic device, the control object may be a haptic object as described in the following paragraphs.

In an embodiment where the robotic device 220 is a haptic device, the processing circuitry 260 is configured to assist the surgeon during implementation of a surgical plan by enabling restraint of the surgical tool 234 during a surgical procedure, such as during preoperative surgery. and generate one or more haptic objects based on the plan. The haptic object may be formed in one, two or three dimensions. For example, a haptic object may be a line, a plane, or a three-dimensional volume. The haptic object may be curved into a curved surface and/or may have a flat surface, and may be of any shape, for example a funnel shape. Haptic objects may be generated to represent various desired outcomes for movement of surgical tool 234 during a surgical procedure. One or more of the boundaries of the three-dimensional haptic object may represent one or more alterations, such as cuts being made to the surface of the bone. A planar haptic object may represent a change such as a cut being made to the surface of a bone. The curved haptic object may represent the resulting surface of the bone as it is modified to accommodate the cup implant and/or implant reinforcement. The line haptic object may correspond to a pilot hole made in the bone to prepare the bone to receive a screw or other protrusion.

In embodiments where robotic device 220 is a haptic device, processing circuitry 260 is further configured to generate a virtual instrumental representation of surgical tool 234 . The virtual tool includes one or more haptic interaction points (HIPs), which represent and are associated with locations on the physical surgical tool 234 . In embodiments where the surgical tool 234 is a spherical burr (eg, as shown in FIG. 2 ), the HIP may represent the center of the spherical burr. When one HIP is used to virtually represent a surgical tool, the HIP may be referred to herein as the tool center point (TCP). If the surgical tool 234 is of an irregular shape, for example an orthopedic saw, the virtual representation of the orthopedic saw may include numerous HIPs. The use of multiple HIPs to generate haptic forces (eg, positive force feedback or resistance to movement) in a surgical tool is described in "System and Method for Providing Substantially," which is incorporated herein by reference in its entirety. Stable Haptics," as described in U.S. Patent Application Serial No. 13/339,369, filed December 28, 2011. In one embodiment of the present invention, the virtual tool representing the orthopedic saw comprises 11 HIPs. As used herein, reference to “HIP” is considered to also include reference to “one or more HIPs”. As described below, the relationship between the HIP and the haptic object enables the surgical system 200 to constrain the surgical tool 234 .

Prior to performing a surgical procedure, the patient's anatomy (eg, femur 206 ) may be registered with a virtual bone model of the patient's anatomy by any known registration technique. One possible registration technique is point-based registration as described in U.S. Patent No. 8,010,180, issued August 30, 2011, entitled "Haptic Guidance System and Method," which is incorporated herein by reference in its entirety. to be. Alternatively, registration may be made for a hand held as described in U.S. Patent Application Serial No. 13/562,163, filed July 30, 2012, entitled “Radiographic Imaging Device,” which is incorporated herein by reference in its entirety. It may be performed by 2D/3D registration using a radiographic imaging device. The registration also includes registration of the surgical tool 234 to a virtual instrumental representation of the surgical tool 234 , such that the surgical system 200 provides the surgical tool 234 to the patient (ie, to the femur 206 ). can determine and monitor the posture of Registration allows for accurate navigation, control and/or force feedback during surgical procedures. Additional details related to enrollment in hip arthroplasty in some embodiments are detailed below.

Processing circuitry 260 may be configured to represent one or more lines, planes, or three-dimensional spaces defined by forces generated by the patient's bone (eg, femur 206 ), surgical tool 234 , and robotic device 220 . and monitor the virtual tool representation corresponding to the real-world location, the virtual bone model, and the virtual location of the control object (eg, the virtual haptic object). For example, if the patient's anatomy moves during a surgical procedure as tracked by tracking system 222 , processing circuitry 260 moves the virtual bone model correspondingly. Thus, the virtual bone model corresponds to or relates to the patient's real (ie, physical) anatomy and the position and orientation of that anatomy in real/physical space. Similarly, any haptic object, control object or other planned automated movement of the robotic device generated during surgical planning, also related to cuts, changes, etc. to be made to that anatomy, moves in response to the patient's anatomy. In some embodiments, surgical system 200 includes a clamp or brace that substantially secures femur 206 to minimize the need to track and process motion of femur 206 .

For embodiments in which the robotic device 220 is a haptic device, the surgical system 200 is configured to constrain the surgical tool 234 based on the relationship between the HIP and the haptic object. That is, when the processing circuit 260 uses the data supplied by the tracking system 222 to detect that the user manipulates the surgical tool 234 to put the HIP into virtual contact with the haptic object. generates a control signal for the robotic arm 232 to provide haptic feedback (eg, force, vibration) to the user to convey a restriction on movement of the surgical tool 234 . Generally, as used herein, the term “restriction” is used to describe a tendency to limit movement. However, the type of restriction imposed on the surgical tool 234 depends on the type of the associated haptic object. The haptic object may be formed into any desired shape or configuration. As noted above, three exemplary embodiments include lines, planes, or three-dimensional volumes. In one embodiment, surgical tool 234 is limited because the HIP of surgical tool 234 is limited to movement along a linear haptic object. In another embodiment, the haptic object is a three-dimensional volume, and the surgical tool 234 may be constrained by substantially preventing movement of the HIP outside the volume surrounded by walls of the three-dimensional haptic object. In another embodiment, the surgical tool 234 is limited because the planar haptic object substantially prevents movement of the HIP outside of the plane and outside the boundaries of the planar haptic object. For example, processing circuitry 260 may be configured to correspond to the planned planar distal cut required to create a distal surface on the femur 206 to substantially localize the surgical tool 234 to a plane necessary to perform the planned distal cut. A planar haptic object can be established.

For embodiments in which the robotic device 220 is an autonomous device, the surgical system 200 is configured to autonomously move and actuate the surgical tool 234 according to a control object. For example, the control object may define an area related to the femur 206 in which an amputation is to be made. In this case, one or more motors, actuators, and/or other mechanisms of robotic arm 232 and surgical tool 234 may use tracking data from tracking system 222 to allow closed loop control, for example. , is controllable to move and actuate the surgical tool 234 as needed within the control object to make the planned cut.

Referring now to FIG. 3 , a flowchart of a process 300 that may be executed by the surgical system 200 of FIG. 2 is shown in accordance with an exemplary embodiment. Process 300 may be configured to facilitate various surgical procedures, including total and partial joint replacement surgery. Process 300 may be practiced using the various steps and features illustrated in FIGS. 4-13 and is described in detail below, including combinations thereof.

At step 302 , a surgical plan is obtained. A surgical plan (eg, a computer readable data file) may define a desired outcome of a defined bone alteration based on, for example, a desired position of a prosthetic component relative to a patient's anatomy. For example, in the case of knee arthroplasty, the surgical plan may provide the planned location and orientation of the planar surfaces 102 - 110 and the pilot hole 120 as shown in FIG. 1 . The surgical plan may be generated based on a medical image, 3D modeling, a doctor's input, and the like.

In step 304, one or more control boundaries, such as haptic objects, are defined based on the surgical plan. The one or more haptic objects may be one-dimensional (eg, line haptic), two-dimensional (ie, planar), or three-dimensional (eg, cylindrical, funnel-shaped, curved, etc.). The haptic object is the planned bone alteration defined by the surgical plan (eg, the haptic object for each of the respective planar surfaces 102 - 110 and pilot hole 120 shown in FIG. 1 ), the implant component, and the surgical approach trajectory. etc. can be shown. The haptic object may be oriented and positioned in three-dimensional space based on the tracked position of the patient's anatomy.

At step 306 , the posture of the surgical tool is tracked relative to the haptic object(s), for example by the tracking system 222 described above. In some embodiments, a point on the surgical tool is tracked. In another embodiment (eg, in the example of FIGS. 4-5 ) two points on the surgical tool, eg the tool center point (TCP) at the tip/effective end of the surgical tool and the body or handle portion of the surgical tool A second interaction point (SIP) arranged along is tracked. In another embodiment, three or more points on the surgical tool are tracked. The pose of the surgical tool is identified against a coordinate system in which one or more haptic objects are defined and in some embodiments the pose of one or more anatomical features of the patient is also tracked.

In step 308, the surgical tool is guided to the haptic object(s). For example, the display 264 of the surgical system 200 may be a graphic instructing the user on how (eg, in which direction) to move the surgical tool and/or robotic device to bring the surgical tool to the haptic object. A user interface can be displayed. As another example, a surgical instrument may be guided to a haptic object using a collapsing haptic boundary as described in US Pat. No. 9,289,264, the entire disclosure of which is incorporated herein by reference. As another example, a robotic device can be controlled to automatically move a surgical tool to a haptic object. As another example, step 308 may be executed using process 800 of FIG. 8 detailed below.

At step 310 , the robotic device is controlled to limit movement of the surgical tool based on the tracked pose of the surgical tool and the pose of the one or more haptic objects. Restriction of the surgical tool may be achieved as described above with reference to FIG. 2 . In some embodiments, step 310 includes a two-step approach illustrated in FIGS. 4-5 and described with reference to the following. In some embodiments, step 310 includes, for example, providing a damping force that resists movement of the surgical tool through a particular region shown in FIGS. 9-10 and described with reference to below. In some embodiments, step 310 includes adjusting the haptic interaction in response to a user input, for example according to the example of FIGS. 11-13 described with reference to the following. Various combinations of these features are possible in step 310 .

In step 312, ejection of the surgical tool from the haptic object(s) is facilitated, ie, releasing the restrictions of the haptic object. For example, in some embodiments, the robotic device is controlled to allow a surgical tool to exit the haptic object along an axis of the haptic object. In some embodiments, as shown in, for example, FIGS. 6-7 and detailed below with reference, the surgical tool may be allowed to exit the haptic object in a predetermined direction relative to the haptic object. This allows surgical tools to be removed from the surgical area and haptic object to facilitate subsequent steps in the surgical procedure. It should also be understood that in some cases, process 300 may return to step 308 where the surgical tool is guided to the same or a different haptic object after exiting the haptic object at step 312 .

Process 300 may be executed by surgical system 200 to facilitate a surgical procedure. Features of the process 300 are illustrated below in FIGS. 4-13 in accordance with some embodiments, and such features may be combined in various embodiments and/or in various combinations based on selected settings for a particular surgery. It should also be understood that the features of FIGS. 4-13 may be provided while some or all steps of the process 300 are omitted. All such possibilities are within the scope of the present disclosure.

Referring now to Figures 4-5, a two-step haptic interaction is illustrated in accordance with an exemplary embodiment. FIG. 4 shows a flow diagram of a process 400 for providing a two-step haptic interaction, and FIG. 5 shows a storyboard style example of a two-step haptic interaction (ie, of process 400). Process 400 may be executed, for example, by surgical system 200 at step 310 of process 300 .

At step 402 , tool center point (TCP) 500 is lined while allowing rotation of surgical tool 234 relative to tool center point 500 and translation of TCP 500 along line haptic 502 . Limited to haptics 502 . The line haptic 502 may correspond to a projected bone deformation, eg, a projected pilot hole 120 as shown in FIG. 1 . Line haptic 502 may be defined as the axis of projected pilot hole 120 , and the bottom (deepest end) of projected pilot hole 120 extending beyond an anatomical feature (eg, femur 101 ). ) can be extended from Line haptic 502 is a straight line in the example of FIG. 5 . In other embodiments, the line haptic 502 may be curved, for example defined as a spline. In another embodiment, process 400 of FIG. 4 is adapted to use a haptic object defined as any combination of line, plane, and/or volume in place of a planar haptic object, a volumetric haptic object, or line haptic 502 . can be

TCP 500 is tracked for line haptic 502 , and the robotic device is controlled to constrain TCP 500 to remain on or substantially on line haptic 502 (eg, line haptic). a spring force that drives TCP 500 back to line haptic 502 to prevent or resist deviation from 502, etc.). TCP 500 may be translated along line haptic 502 in step 402 . The robotic device is controlled (eg, via admittance control) such that the surgical tool 234 can be rotated (eg, when manipulated by a user) about the TCP 500 . That is, the second interaction point (SIP) 504 positioned along the handle or body portion of the surgical tool 234 is not limited at step 402 .

Rotation of surgical tool 234 relative to TCP 500 at step 402 may facilitate the surgeon to reach line haptic 502 along a desired approach trajectory. In some cases, the surrounding soft tissue and/or bone structures can be line haptic 502 without undesirable or unnecessary disruption to the surrounding tissue or bone (eg, without the need to form a hole through such tissue or bone). may make it difficult or impossible to insert the surgical tool 234 from a position completely external to the patient into the bone surface along the In this case, the surgical tool 234 may be inserted along the preferred trajectory until the TCP 500 reaches the line haptic 502 and is constrained by the line haptic 502 . At step 402 , the surgical tool 234 may be rotated to displace the anatomical feature by forcing it to the side of the body or shaft of the surgical tool. By limiting TCP 500 to line haptics 502, the surgeon monitors the position of TCP 500 and/or steps ( At 402 , the focus may be on rotating the surgical tool 234 as desired. Step 402 may accordingly facilitate insertion and orientation of surgical tool 234 in various anatomical regions.

At step 404 , a determination is made (eg, by processing circuitry 260 ) that TCP 500 has reached a threshold position along line haptic 502 . In some cases, the critical position is defined based on a distance spaced apart from the surface of the bone (eg, the femur 101 ) such that the surgical tool 234 reaches the critical position before contacting the bone. In such a case, steps 406 - 408 may be performed as described below before the surgical tool 234 begins to alter the bone, thereby establishing the desired orientation of the surgical tool 234 prior to initiating the bone altering. can guarantee

In other cases, the critical position is defined based on a depth below the surface of the bone, such that the critical position is reached after the surgical tool 234 comes into contact with the bone. In this case, the surgical tool 234 may be, for example, line haptic as described below with respect to steps 406 - 408 to reduce the risk of skiving or otherwise facilitate entry of the surgical tool 234 into the bone. may allow the bone to begin to change to the first orientation before rotating to align with 502 . As shown in FIG. 5 , for example, as shown in the upper frame (ie, during step 402 ), the surgical tool makes initial contact between the bone 101 and the surgical tool 234 approximately perpendicular to the surface of the bone. This can be done, which can improve the tendency to achieve a clean initial cut/bore/drill/etc into the bone 101 at the planned location (ie, the intersection between the line haptic 502 and the bone 101 ). In this case, a determination that TCP 500 has reached the critical position may then be made after initial penetration of surgical tool 234 into bone 101 (ie, TCP 500 has reached the surface of bone 101 ). to cross).

At step 406 , in response to determining that the TCP 500 has reached the threshold position at step 404 , the SIP 504 is directed towards the line haptic 502 . In some embodiments, the robotic device may control to provide an assistive force to help the user rotate the surgical tool 234 around the TCP 500 to move the SIP 504 towards the line haptic 502 . . In some embodiments, a reduced haptic object is used in step 406 that allows rotation of the SIP 504 towards the line haptic 502 while preventing rotation of the SIP 504 away from the line haptic 502 . In some embodiments, directing the SIP 504 to the line haptic 502 is accomplished by presenting a command via the display 264 . In some embodiments, guiding the SIP 504 towards the line haptic 502 may be accomplished by controlling the robotic device to automatically rotate the surgical tool 234 to align the SIP 504 with the line haptic 502 . is achieved TCP 500 is limited to line haptics 502 (described with respect to step 402 ) during step 406 (ie, while SIP 504 is guided to line haptics 502 ). In some cases, the robotic device is controlled to prevent translation of the TCP 500 along the line haptic 502 while the SIP 504 is guided to the line haptic 502 during step 406 .

In step 408 , after SIP 504 is guided to line haptic 502 as a result of step 406 , the robotic device controls TCP 500 and SIP 504 to limit to line haptic 502 . do. The surgical tool 234 may translate along the line haptic 502 to effect the planned bone alteration (eg, to create the pilot hole 120 ). In the illustrated example, the SIP 504 is positioned along the axis of the surgical tool 234 . Accordingly, the alignment of the line haptic 502 and the surgical tool 234 is maintained by limiting two points of the other surgical tool 234 to the line haptic 502 (ie, TCP 500 and SIP 504 ). . In another embodiment, the SIP 504 is guided to a second haptic (ie, a virtual haptic object different from the line haptic 502 ). In this embodiment, TCP 500 and SIP 504 are limited to different haptic objects. For example, if surgical tool 234 is curved, SIP 504 may be constrained to a curve and TCP 500 may be constrained to a straight line (or vice versa) and the desired degree of freedom of surgical tool 234 . and movement restrictions are achieved.

Other geometries and behaviors may also be possible by using different haptic objects for SIP 504 and TCP 500 . For example, TCP 500 may be limited to a haptic object corresponding to the geometry of a planned cutting or drill path and SIP 504 may be limited to one or more objects in the surgical area and a shaft (or robotic arm) of surgical tool 234 . are limited to different haptic objects configured to prevent or resist collisions between different points on the image. For example, SIP 504 may be limited to a haptic object having a geometry based on the position of the retractor or other instrument in the surgical area (eg, tracked retractor position). As another example, the SIP 504 may be configured based on the location of an anatomical feature corresponding to the shape of a surgical port or other incision or opening, eg, through which the shaft of the surgical tool 234 extends during execution of the planned bone preparation. It may be limited to haptic objects with geometrical structures. Accordingly, the control of the robotic device is configured to restrict TCP 502 to a first haptic object and to restrict SIP 504 to a second haptic object to guide TCP 502 according to the planned bone preparation and simultaneously SIP. Limiting 504 prevents unwanted movement of the tool shaft. Thus, process 400 may be executed by surgical system 200 to provide accurate bone deformation in a reliable and intuitive manner.

Referring now to FIGS. 6-7 , shown is a process 600 for facilitating ejection of a surgical tool from a haptic object in accordance with an exemplary embodiment. 6 shows a flow diagram of a process 600 , and FIG. 7 shows a haptic object that may be used with the process 600 of FIG. 6 . Process 600 may be executed, for example, by surgical system 200 at step 312 of process 300 . 6-7 contemplates cylindrical haptic objects, it should be understood that process 600 may be adapted to control objects having various geometries.

At step 602 , the robotic device is controlled to confine the surgical tool 234 to a cylindrical haptic object. 7 shows an example of a cylindrical haptic object 700 centered on target axis 702 . In some embodiments, the cylindrical haptic object 700 corresponds to a surgical access trajectory and/or a projected bone deformation (eg, projected pilot hole 120 ). Cylindrical haptic object 700 may extend substantially beyond (spaced from) the sensitive anatomical region. With surgical tool 234 confined to cylindrical haptic object 700 , surgical tool 234 may partially impede access to the surgical area. Accordingly, it may be desirable for the surgeon to move the surgical tool out of the cylindrical haptic object 700 in a safe direction to facilitate various steps of the surgical procedure.

At step 604 , a force on the surgical tool 234 applied against the boundary of the cylindrical haptic object is detected. The force may be detected by the robotic device 220 , for example as a wrench applied to a joint of the robotic arm 232 . For example, a HIP associated with surgical tool 234 may be positioned at the boundary of cylindrical haptic object 700 while the user exerts a force to press surgical tool 234 against or into the boundary of surgical tool 234 . apply force to

At step 606 , a determination is made (eg, by processing circuitry 260 ) as to whether the force detected at step 604 is oriented in a predetermined ejection direction. The predetermined ejection direction may be selected as a safe and/or convenient direction in which the surgical tool 234 may be allowed to eject the haptic object. For example, the predetermined ejection direction is defined by an ejection region 704 of the cylindrical haptic object 700 and a wall 706 extending from the cylindrical haptic object 700 in the ejection region 704 . In this example, the processing circuit 260 determines that the force is oriented in a predetermined ejection direction when the HIP of the surgical tool 234 is in the ejection area 704 because the force opposes the boundary of the cylindrical haptic object 700 . can decide In some embodiments, the ejection area 704 spans only a portion of the length of the haptic object 700 that is blocked by a dead zone 708 , for example, as shown in FIG. 7 . As another example, in some embodiments processing circuitry 260 may determine a direction vector toward a direction in which the user is pressing the tool. In this case, it may be determined whether the direction vector is within a predetermined critical angle of the discharge direction. In this example, if the direction vector is within a critical angle of the predetermined ejection direction, the force is considered directed in the predetermined ejection direction (ie, “Yes” at step 606 ). The resulting discharge boundary may take the shape of a funnel.

If the force is not directed in the predetermined ejection direction, process 600 returns to step 602 and surgical tool 234 is limited to cylindrical haptic object 700 . That is, the robotic device 220 is controlled to provide force feedback to limit ejection of the surgical tool from the cylindrical haptic object 700 , for example, to facilitate one or more steps of a surgical procedure.

Once the force is oriented in a predetermined ejection direction (as determined in step 606 ), a determination is made in step 608 as to whether the force is greater than a threshold amount of force (eg, by processing circuitry 260 ). ). In some embodiments, the amount of force applied to the surgical tool 234 may be measured by the articulation of the robotic arm 232 . A user may indicate a desire to eject the haptic object by exceeding a threshold amount of force, while the threshold amount of force may be set high enough to substantially prevent accidental or unintentional ejection from the haptic object.

If the force is less than a threshold amount of force, the robotic device 220 is controlled to restrict the surgical tool 234 from ejecting the haptic object (eg, passing through the ejection area 704 of the cylindrical haptic object 700 ). from doing). Process 600 returns to step 602 and surgical tool 234 continues to be limited to cylindrical haptic object 700 to facilitate use of surgical tool 234 when performing steps of a surgical procedure.

If the force is determined to exceed a threshold amount of force in step 608 , then in step 610 the surgical tool allows ejecting the haptic object in a predetermined ejection direction. In the example of FIG. 7 , the constraint associated with the ejection region 704 is removed to allow the surgical tool 234 to move through the ejection region 704 to eject the cylindrical haptic object 700 . Wall 706 may be included as a haptic boundary to guide surgical tool 234 away from axis 702 in a predetermined direction. In other words, the surgical tool 234 may be pressed across the ejection area 704 of the cylindrical haptic object 700 to eject the cylindrical haptic object in a predetermined direction.

Accordingly, the surgical tool 234 is allowed to eject the haptic object so that the robotic device is no longer controlled to limit the surgical tool 234 to the haptic object. In some cases, surgical tool 234 may be reinserted into the haptic object via ejection region 704 and/or using any other haptic initiation procedure (eg, following the process of FIG. 8 ). i.e. to restart the haptic constraint). In some cases, the haptic object is removed (deleted, etc.) when the surgical tool 234 ejects the haptic object. In some cases, the haptic object is adjusted or a new haptic object is activated to facilitate subsequent steps in the surgical procedure. Process 600 may thus be executed one or more times by a surgical procedure to facilitate the surgical procedure.

Referring now to FIG. 8 , there is shown a flow diagram illustrating a process 800 for guiding a surgical tool to a virtual control object (eg, a haptic object) in accordance with an example embodiment. Process 800 may be executed, for example, by surgical system 200 at step 308 of process 300 .

In step 802, a virtual control object is established. That is, a virtual control target is created and the posture of the virtual control target is defined. The virtual control object may include one or more of a point object, a line object, a planar object, or a three-dimensional surface or volume as detailed above with reference to FIG. 2 . In some cases the virtual control object is a haptic object. Process 800 may be adapted for use with various virtual control objects having various shapes.

At step 804 , movement of the surgical tool 234 is tracked (eg, by the tracking system 222 ). For example, the location of a point associated with surgical tool 234 (eg, a tool center point) may be determined and updated over time. The position of the point may be defined with respect to the virtual control object, ie in a coordinate system in which the posture of the virtual control object is also defined. The surgical tool 234 may be moved by a user's manipulation.

At step 806 , a direction of movement of the surgical tool is determined (eg, by processing circuitry 260 ). For example, the location of a point associated with the surgical tool 234 may be repeatedly collected over time to obtain a time series of location data. Given two positions (eg, for a subsequent time step), a vector (eg, velocity vector) characterizing the direction of movement of the surgical tool 234 may be defined. In some cases, the speed of movement (eg, the magnitude of the speed vector) is determined based on the distance between the locations used and the elapsed time between collecting these data points. In some cases, process 800 does not proceed to step 808 unless the magnitude of the velocity vector exceeds a threshold.

At step 808 , a determination is made (eg, by processing circuitry 260 ) as to whether the direction of movement is towards the virtual control object. For example, the velocity vector determined in step 806 may extend (eg, indefinitely) in the direction of movement from the most recently tracked position of the surgical tool. For example, when the extended velocity vector intersects the virtual control object, it may be determined that the moving direction is toward the virtual control object. When the extended velocity vector does not intersect the virtual control object, it may be determined that the moving direction does not face the virtual control object. Various other statistical methods, coordinate transformations, etc. may be used in various embodiments to determine whether the direction of movement of the surgical tool is toward the virtual control object. For example, in some embodiments a target volume is defined at (eg, around, adjacent to, extending from) a virtual control object, and the direction of movement is virtual control when the expanded velocity vector intersects the target volume. It can be determined to be directed towards the target. When the virtual control object is a line, the target volume may be defined as, for example, a cylinder centered on the line.

If the direction of movement is not towards the virtual control object, the process 800 returns to step 804 where the movement of the surgical tool 234 is tracked. Steps 804-808 may be repeated until the direction of movement is toward the virtual control object.

If it is determined that the direction of movement is toward the virtual control object, in step 810 the robotic device 220 is controlled to provide a force to guide the surgical tool 234 toward the virtual control object. For example, a positive assisting force may be provided to assist the user in moving the surgical tool 234 towards the virtual control object. The positive assist force may be insufficient to independently move the surgical tool 234 without an external force provided by the user. In some cases, the force applied at step 810 causes the surgical tool to automatically move (without user intervention) to the virtual control object. As another example, in some embodiments a force is a haptic boundary (eg, a collapsing haptic boundary) that limits deviations from the direction of movement of the surgical tool 234 away from and/or toward the virtual control object. is provided as

As such, surgical system 200 may execute process 800 to facilitate a user moving a surgical tool to a virtual control object in response to a user initiated movement of the surgical tool toward the virtual control object. For example, various movements of the surgical tool away from the virtual control object to properly position the surgical tool 234 , robotic arm 232 , anatomy, other surgical equipment, etc. before use of the virtual control object is required. may be desirable. Process 800 provides a user-friendly and efficient workflow in which surgical tools can be moved freely until they are moved towards a virtual control object (eg, towards a surgical field in which the virtual control object is located); At this point, the system 200 automatically initiates guiding the surgical tool to the virtual control object.

Referring now to FIGS. 9-10 , illustrated is a process for providing a haptic interaction comprising an attenuation zone in accordance with an exemplary embodiment. 9 shows a process 900 for providing a haptic interaction that includes an attenuation zone, while FIG. 10 shows an example haptic object that includes an attenuation zone. Process 900 may be executed, for example, by surgical system 200 at step 310 of process 300 . For example, although a cylindrical haptic object is shown in FIG. 10 , it should be understood that the features of FIGS. 9-10 may be adapted for use with virtual control objects of various geometries.

At step 902 , a haptic object having an attenuation zone is established (eg, defined in virtual space by processing circuitry 260 ). An attenuation zone may be defined as a sub-portion of a haptic object and/or an area within the haptic object. An exemplary haptic object 1000 having an attenuation zone 1002 is shown in FIG. 10 . As shown in FIG. 10 , haptic object 1000 is a cylindrical haptic object and attenuation zone 1002 is a cylindrical disk positioned on haptic object 1000 . In the example of FIG. 10 , haptic object 1000 and attenuation zone 1002 have the same diameter while the height of attenuation zone 1002 is significantly lower than the height of haptic object 1000 and is centered on shared axis 1004 . . In other embodiments, various relative sizes and dimensions are possible.

In some examples, attenuation zone 1002 is positioned along haptic object 1000 proximate to a surface of an anatomical feature (eg, bone). For example, the damping zone 1002 may be on the outer side of the bone surface. In this case, as tracked surgical tool 234 approaches the bone while constrained by haptic object 1000 , surgical tool 234 first reaches attenuation zone 1002 .

At step 904 , a determination is made that the surgical tool 234 has entered the first side of the attenuation zone 1002 (eg, by the processing circuit 260 using data from the tracking system 222 ). this is done In the example of FIG. 10 , the position of the TCP of the surgical tool 234 can be tracked with respect to the attenuation zone 1002 , wherein the surgical tool 234 intersects the TCP with a first surface 1006 of the attenuation zone 1002 . may be determined to have entered the first side of the damping zone 1002 when

At step 906 , the robotic device 220 is controlled to provide haptic feedback that partially resists movement of the surgical tool through the damping zone. For example, control of the robotic device 220 based on the damping zone may cause movement of the surgical tool 234 to be slow (eg, not exceeding a preset speed) as the surgical tool 234 passes through the damping zone. ) can cause In the case where the damping zone is located on the surface of the bone, the damping zone may thus act to manage (eg, reduce) the rate of translational movement of the surgical tool 234 at the initial impact between the surgical tool 234 and the bone. . By reducing the speed of translational movement of the surgical tool 234, the damping zone provided by the process 900 will reduce skiving, increase the quality of the cut or bore/drill hole, and increase the accuracy of the cut or hole placement. can

Although Figures 9-10 show a damping zone in which the movement of the robotic device 220 is damped as described above, other embodiments provide other types of regions associated with different effects, in this case step 906 . is adapted accordingly. For example, in some embodiments the damping zone is replaced with an acceleration zone in which the robotic device 220 causes the speed of the surgical tool 234 to increase as it passes the acceleration zone in step 906 . As another example, in some embodiments, the attenuation zone is replaced with a manpower zone, in which the robotic device 220 is a surgical tool (eg, a midpoint of the manpower zone) oriented towards a location within the force zone. Controlled to provide a force to 234 , or replaced with a reaction zone in which the robotic device 220 is controlled to provide a force to a surgical tool 234 oriented away from the location of the reaction zone.

At step 908 , a determination is made (eg, by processing circuitry 260 using data from tracking system 222 ) that the surgical instrument has been ejected from the second side of the attenuation zone. In the example of FIG. 10 , the position of the TCP of the surgical tool 234 can be tracked with respect to the attenuation zone 1002 , and the surgical tool 234 is such that the TCP passes through the second side 1008 of the attenuation zone 1002 . may be determined to have been discharged from the second side of the attenuation zone 1002 .

At step 910 , in response to determining that the surgical instrument has been ejected from the second side of the attenuation zone, the attenuation zone is removed from the haptic object (eg, by processing circuitry 260 ). The resistive feedback applied in step 906 is no longer applied. In some embodiments, the surgical tool may repeatedly pass through the area previously occupied by the damping zone without experiencing the resistance of step 906 . Accordingly, the surgical system 200 may be configured to provide damping resistance to facilitate initial contact between the surgical tool 234 and the bone, and to automatically remove such resistance after the initial contact.

Referring now to FIGS. 11-13 , adjusting a haptic interaction in response to input received from a user via a button (key, trigger, switch, pressure sensor, hand position sensor, etc.) mounted on a surgical tool or robotic arm. A flowchart illustrating a process for Referring to FIG. 2 , the process of FIGS. 11-13 takes into account the buttons located in the grip or handle area of the robotic arm 232 or surgical tool 234 , allowing the user to engage the robotic arm 232 and the surgical procedure during execution of the surgical procedure. Make buttons readily available to a user (eg, a surgeon) while manipulating the tool 234 . The button may be selected by the user without requiring the user to change the user's grip on the robotic arm 232 and/or the surgical tool 234 and without requiring the user to divert the user's sight or attention from the surgical area. have. The process of FIGS. 11-13 may be executed by the surgical system 200 , for example, as part of step 310 of FIG. 3 .

11 shows a flow diagram of a process 1100 in which a button causes a user to toggle between a first haptic object and a second haptic object. At step 1102 , surgical tool 234 is restricted to a first haptic object. The first haptic object can have any of the dimensions, shapes, etc. described herein. At step 1104 , an electrical signal is received (eg, at processing circuitry 260 ) indicative of a press of a button mounted on a surgical tool or robotic arm. At step 1106 , haptic control of the surgical tool 234 is switched from a first haptic object to a second haptic object, so that at step 1108 , the surgical tool 234 is limited to the second haptic object. In some cases, the button may be pressed again to return to control based on the first haptic object.

Process 1100 may provide various advantages based on the relative sizes, shapes, etc. of the first and second haptic objects. In some embodiments, the first haptic object is a sub-portion of the second haptic object (ie, such that the second haptic object allows a greater range of motion than the first haptic object). In this case, the user may select a button that allows the surgical tool 234 to reach an area where the surgical tool 234 has been restricted from reaching under control based on the first haptic object. One example is a set of planar haptic objects, wherein a first haptic object corresponds to a virtually determined range of planar cuts, while a second haptic object is a larger coplanar object. Based on the surgeon's experience and intraoperative observations, the surgeon can, if necessary, extend the intraoperative amputation at the push of a button. As another example, the first haptic object and the second haptic object may only partially overlap. In this example, process 1100 may facilitate transitioning between different steps of a surgical procedure. In some embodiments, processing circuitry 260 prevents switching between haptic control objects unless a surgical tool is currently located within both haptic objects.

12 depicts a process 1200 in which the button causes the haptic object to expand in the direction of a force applied by the user. In step 1202, the surgical tool is restricted to the first haptic object. The first haptic object can have any of the dimensions, shapes, etc. described herein. At step 1204 , an electrical signal is received (eg, at processing circuitry 260 ) indicative of a press of a button mounted on a surgical tool or robotic arm.

At step 1206 , in response to a signal from the button, a direction of a force applied to the surgical tool is determined (eg, by processing circuitry 260 ). The HIP of the surgical tool may be positioned at the boundary of the first haptic object such that the haptic control interaction prevents the force from causing the surgery to move further in the direction of the force. In this scenario, pressing the button indicates that the user wants to further move the surgical tool in the direction of the force. Thus, at step 1208 , the first haptic object extends in the direction of the force, whereby the surgical tool can be moved further in that direction before being constrained by the first haptic object. The first haptic object may be extended by a preset distance or volume in step 1208 . The surgical tool is then constrained by the elongated first haptic object.

Process 1200 may thereby facilitate a user to extend the surgical tool beyond the first haptic object in a particular user-selected direction. For example, in some cases, control based on a first haptic object may restrict the surgical tool from reaching the full extent of anatomical features that the surgeon wishes to modify into the surgical tool. The surgeon may then force the surgical tool towards the target feature and select a button to cause the haptic object to expand towards the target feature. Process 1200 accordingly facilitates advantageous intraoperative adjustments to the haptic object.

13 depicts a process 1300 of adjusting a virtual control interaction by a button allowing a user to adjust a virtual dimension of a virtual tool. In embodiments contemplated by process 1300 , the haptic control interaction is achieved by tracking a haptic interaction point (eg, TCP) associated with the surgical tool. HIP is a one-dimensional point. The processing circuitry uses one or more virtual dimensions of the surgical tool to determine a volume occupied by the surgical tool based on the location of the HIP. For example, for a spherical burr, the HIP can be located at the center of the spherical burr, and the radius of the burr can be used to determine the three-dimensional volume occupied by the spherical burr based on the HIP position and radius dimensions in virtual space. Haptic control is provided based on the interaction between the haptic object and the volume occupied by the surgical tool (or its boundary). In the example of a spherical burr, the HIP may be limited to a location offset from the haptic boundary by at least the radial dimension of the spherical burr. In this case, changing the virtual radius of the spherical burr can move the HIP closer to the haptic boundary. The control of the robotic device can thus be changed by changing the virtual dimensions of the surgical tool.

In step 1302, the surgical tool is restricted to the first haptic object. The first haptic object can have any of the dimensions, shapes, etc. described herein. At step 1304 , an electrical signal is received (eg, at processing circuitry 260 ) indicative of a press of a button mounted on a surgical tool or robotic arm. At step 1306 , a virtual dimension of the surgical tool is adjusted (eg, by processing circuitry 260 ) in response to a signal from the button. For example, in a scenario where the surgical tool is a spherical burr, the virtual radius of the spherical bur may be reduced.

At step 1308 , the robotic device is controlled to constrain the surgical tool to the first haptic object based on the adjusted virtual dimensions of the surgical tool. In an example where the virtual dimension of the surgical tool is reduced (eg, when the radius is reduced), the surgical tool may be provided with a greater range of motion in step 1308 as compared to step 1302 . In this case, the surgeon may engage the button when it wishes to allow the surgical tool to reach the position where it is restricted to reach at step 1302 . The position of the virtual central point of the surgical tool may also be moved relative to the tracked position of the surgical tool, for example such that the reduced sized virtual tool is aligned with the boundary of the original sized virtual tool. Such movement may provide the surgical tool with greater range of motion in some directions while maintaining range of motion along a shared boundary. For example, when reducing the virtual dimension of a surgical tool, moving the virtual center point toward the distal tip of the surgical tool may allow for an increased range of side-to-side movement (ie, orthogonal to the axis of the surgical tool), whereas surgery Limit the tool to its original cutting depth. Process 1300 may thereby facilitate minor intraoperative adjustments to the extent of anatomical features that may be altered by a surgical tool in accordance with a surgical plan.

In some embodiments, the button may be selected repeatedly to cause iterative adjustments to one or more virtual dimensions of the surgical tool (eg, stepping to smaller and smaller sizes, switching between two available sizes, three Move sequentially through more available sizes, etc.). Many such possibilities are within the scope of the present disclosure.

In other embodiments, the input is received from another source (eg, foot pedal, voice activation, mouse, keyboard, touch screen, etc.). In another embodiment, user input (as described in FIGS. 11-13 as occurring at a button) is replaced with an automatic response based on the tracked position or behavior of the surgical tool and/or robotic device. For example, in some embodiments, a residence time of the surgical tool at the boundary of the haptic object is detected. When the dwell time exceeds the threshold time, the haptic control may be changed as described in steps 1106-1108, 1206-1210, and/or 1306-1308. Various such modifications are within the scope of the present disclosure.

As noted above, all combinations of the various features illustrated in FIGS. 4-13 are within the scope of the present disclosure. For example, process 300 may use steps of one or more of process 400 , process 600 , process 800 , process 900 , process 1100 , process 1200 , and process 1300 . can be implemented. In addition, the various features, methods, steps, and the like described herein can be used to facilitate a variety of surgical procedures, including total and partial hip, knee and shoulder arthroplasty, and to perform non-surgical operations.

The construction and arrangement of systems and methods as shown in the various illustrative embodiments are illustrative only. Although only a few embodiments are described in detail herein, many variations (e.g., size, dimensions, structure, shape and ratio of various elements, values of parameters, mounting devices, uses of materials, colors, orientation, etc.) is possible. For example, the position of elements may be inverted or otherwise changed, and the nature or number of discrete elements or positions may change or change. Accordingly, such modifications are intended to fall within the scope of the present invention. The order or sequence of steps in any process or method may be changed or reordered according to other embodiments. Other substitutions, changes, changes, and omissions may be made in the design, operating conditions, and arrangement of the exemplary embodiments without departing from the scope of the present invention.

As used herein, the terms "approximately," "about," "substantially," and similar terms It is intended to have a broad meaning. It should be understood by those skilled in the art upon reviewing this disclosure that these terms are intended to permit the description of the specific features described and claimed without limiting the scope of those features to the precise numerical ranges provided. Accordingly, such terms should be interpreted as indicating minor or insignificant modifications or variations of the described subject matter and are considered to be within the scope of the present disclosure.

Claims (41)

defining a virtual object;
defining first and second points associated with the virtual representation of the surgical tool, wherein movement of the virtual representation of the surgical tool corresponds to movement of the surgical tool in real space;
controlling a robotic device coupled to the surgical tool to confine the first point to the virtual object;
determining that the first point is at a threshold location along the virtual object; and
and controlling the robotic device to guide the second point to the virtual object. The method of claim 1 , wherein controlling the robotic device to constrain the first point to the virtual object comprises: preventing movement of the first point away from the virtual object and allowing rotation of the surgical tool relative to the first point. A method comprising controlling. According to claim 1,
determining that the second point is located on the virtual object; and
The method further comprising constraining the first point and the second point to the virtual object. 4. The method of claim 3,
detecting a force applied to the tool in a predetermined direction orthogonal to the virtual object;
determining whether a force in a predetermined direction exceeds a threshold force; and
In response to determining that the force in the predetermined direction exceeds the threshold force, the method further comprising: controlling the robotic device so that the first point and the second point deviate from the virtual object. The method of claim 1,
defining an attenuation zone along the virtual object;
determining that the first point is in an attenuation zone;
The method further comprising controlling the robotic device to resist movement of the first point through the damping zone. 6. The method of claim 5,
determining that the first point has passed the damping zone; and
in response to determining that the first point has passed the attenuation zone, removing the attenuation zone from the virtual object. The method of claim 1,
Controlling the robotic device to guide the second point to the virtual object includes controlling the robotic device to provide an assisting force to the surgical tool, wherein the assisting force is oriented to assist movement of the second point on the virtual object. Way. According to claim 1,
determining that the first point is moving towards the virtual object; and
in response to determining that the first point is moving towards the virtual object, controlling the robotic device to provide an assisting force to the surgical tool, wherein the assisting force is oriented to assist movement of the first point in the virtual line. how to be According to claim 1,
receiving a signal; and
and changing a control interaction between the first point and the virtual object in response to the signal. The method of claim 1 , wherein defining the virtual object comprises:
obtaining a surgical plan including a hole planned in the target bone; and
A method comprising aligning the planned hole with the virtual object. The method of claim 1 , wherein the threshold position along the virtual object corresponds to the threshold distance from the anatomical feature. The method of claim 1 , wherein the critical location along the virtual object corresponds to the magnitude of penetration into the anatomical feature. The method of claim 1 , wherein the virtual object is a virtual line. A method of operating a robotic device to which a tool is coupled, the method comprising:
controlling the robotic device to constrain the surgical tool based on the first haptic object;
receiving a signal and a user-defined direction; and
and adjusting the haptic control interaction in response to the signal by expanding the first haptic object in a user-defined direction. 15. The method of claim 14, wherein receiving a user-defined direction comprises determining a direction of a force applied by a user to the tool. 15. The method of claim 14, wherein adjusting the haptic control interaction in response to the signal comprises:
adjusting the virtual dimensions of the tool; and
and limiting the tool to the first haptic object based on the adjusted virtual dimension of the surgical tool. 15. The method of claim 14,
the first haptic object includes a line haptic;
The method of confining the tool to the first haptic object includes limiting a first point associated with the surgical tool to a line haptic. 15. The method of claim 14,
detecting a force applied to the tool in a predetermined direction;
determining whether a force in a predetermined direction exceeds a threshold force; and
responsive to determining whether the force in the predetermined direction exceeds the threshold force, controlling the robotic device such that the tool terminates the haptic control interaction. 15. The method of claim 14,
determining a direction of movement of the surgical tool;
determining whether the direction of movement is toward the first haptic object;
responsive to determining that the direction of movement is toward the first haptic object, guiding the tool to the first haptic object. 15. The method of claim 14,
defining an attenuation zone for the first haptic object;
determining whether the tool is in a damping zone;
The method further comprising controlling the robotic device to resist movement of the surgical tool through the damping zone. 21. The method of claim 20,
determining whether the tool has passed the damping zone; and
and removing the damping zone in response to determining whether the surgical tool has passed through the damping zone. A method of operating a robotic device to which a tool is coupled, the method comprising:
controlling the robotic device to constrain the tool based on the first haptic object;
receiving a signal and a user-defined direction; and
and adjusting the haptic control interaction in response to the signal by adjusting the virtual dimension of the tool. A method of operating a robotic device, comprising:
tracking movement of a tool coupled to the robotic device;
determining the direction of movement of the tool;
determining whether the moving direction is toward the virtual control object; and
responsive to determining that the direction of movement is toward the virtual control object, controlling the robotic device to guide the tool to the virtual control object. 24. The method of claim 23, wherein controlling the robotic device to guide the tool to the virtual control object comprises causing the robotic device to apply a force to the tool in a direction of movement. 25. The method of claim 24, wherein the force is not sufficient to independently move the tool in the direction of movement. 25. The method of claim 24, wherein the force is sufficient to independently move the tool in the direction of movement. 24. The method of claim 23, wherein determining the direction of movement of the tool comprises identifying a velocity vector characterizing the movement of the tool. 24. The method of claim 23, wherein tracking movement of the tool coupled to the robotic device comprises tracking the position of the first point and the second point relative to the virtual control object, the first point and the second point being the tool. is associated with; and
The method is:
controlling the robot device to limit the first point to the virtual control object;
determining that the first point is at a threshold position along the virtual control object; and
The method further comprising controlling the robotic device to guide the second point to the virtual control object. 24. The method of claim 23, further comprising: determining whether the tool is under virtual control; and
A method comprising controlling a robotic device to limit a tool to a virtual control object. 30. The method of claim 29,
detecting a force applied to the tool in a predetermined direction;
determining whether a force in a predetermined direction exceeds a threshold force; and
responsive to determining whether the force in the predetermined direction exceeds the threshold force, controlling the robotic device to allow the tool to move away from the virtual control object. 30. The method of claim 29,
defining an attenuation zone in the virtual control object;
determining whether the tool is in a damping zone;
A method comprising controlling the robotic device to resist movement of the surgical tool through the damping zone. 32. The method of claim 31,
determining whether the tool has passed the damping zone; and
and removing the damping zone from the virtual control object in response to determining whether the first point has passed the damping zone. 30. The method of claim 29,
receiving a signal; and
and adjusting the haptic control interaction in response to the signal. tracking a tool connected to the robotic device;
controlling the robotic device to limit the tool within the virtual control object;
defining an area of the virtual control object;
determining whether the tool is in the zone;
A method comprising controlling the robotic device to resist movement of the tool in the zone. 35. The method of claim 34,
determining whether the tool has passed through the zone; and
responsive to determining whether the tool has passed through the zone, removing the zone from the virtual control object. 35. The method of claim 34,
The method comprising controlling the robotic device to resist movement of the tool in the zone includes controlling the robotic device to prevent a speed of the tool from exceeding a maximum speed. 35. The method of claim 34,
The method of controlling the robotic device to resist movement of the tool in the zone includes controlling the robotic device to provide a force to the tool that opposes a direction of movement of the tool through the zone. 35. The method of claim 34,
detecting a force applied to the tool in a predetermined direction;
determining whether a force in a predetermined direction exceeds a threshold force; and
responsive to determining that the force in the predetermined direction exceeds the threshold force, controlling the robotic device such that the surgical tool ejects the virtual control object. 39. The method of claim 38,
The predetermined direction is orthogonal to the central axis of the virtual control object. A method of operating a robotic device to which a tool is coupled, the method comprising:
limiting the tool to a virtual control object by the robotic device;
detecting a force applied to the tool in an approximately predetermined direction;
determining whether a force in an approximately predetermined direction exceeds a threshold force; and
responsive to determining that the force in the approximately predetermined direction exceeds the threshold force, controlling the robotic device such that the tool ejects the virtual control object. 41. The method of claim 40, wherein the predetermined direction is orthogonal to an axis of the virtual control object.

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